N 1981, IMBACH and colleagues ~ reported the first clinical trial using intravenous immune globulin (IV1G) to treat immune (idiopathic) thrombocytopenic purpura (ITP).~ This study was initiated after the publication of a report that 2 patients with congenital agammaglobulinemia and thrombocytopenia had increased platelet counts after treatment with IVIG, as well as a report of increased platelet counts in a child with ITP after "desensitization" with IVIG. 2 Imbach and colleagues ~ reported favorable outcomes in 7 children with chronic ITP and 6 with acute ITP who were treated with IVIG (Immunoglobuline SKR, Swiss Red Cross, Berne, Switzerland). They suggested that the mode of action of the effect of IVIG in ITP may be "overloading and blocking of the reticuloendothelial system by IgG catabolism, m These findings in children with ITP were confirmed by other investigators, for children and adults with